Central Venous Catheterization
Conditions
Keywords
axillary vein, central venous catheterization, ultrasound, cardiac surgery, complication
Brief summary
Ultrasound-guided axillary vein catheterization can be performed via the oblique-axis and long-axis approaches of the axillary vein. The aim of our study is to compare the first puncture success rate and safety between the two approaches of ultrasound-guided axillary vein catheterization in cardiac surgical patients with high bleeding risk
Detailed description
For patients after cardiac surgery, antiplatelet drugs or anticoagulants are usually used for preventing thrombosis. Use of those drugs is associated with increased risk of bleeding. Any invasive procedures may put those patients at additional risk of bleeding. Ultrasound (US) has become widely accepted to guide safe and accurate central venous catheterization. Ultrasound-guided axillary vein catheterization can be performed via the oblique-axis and long-axis approaches of the axillary vein. The aim of our study is to compare the first puncture success rate and safety between the two approaches of ultrasound-guided axillary vein catheterization in cardiac surgical patients with high bleeding risk
Interventions
PROCEDUREOblique-axis approach group
The first two attempts via the oblique-axis approach will be performed . If the first two attempts failed, the subsequent attempts of venipuncture were performed using the long-axis approach.
PROCEDURELong-axis approach group
The first two attempts via the long-axis approach will be performed . If the first two attempts failed, the subsequent attempts of venipuncture were performed using the oblique-axis approach.
Sponsors
Guowei Tu
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Cardiac surgical patients in Cardiac Surgery Intensive Care Unit * Axillary vein catheterization is needed according to the clinical practice
Exclusion criteria
* the proximal and/or distal axillary vein was not clearly visualized or potentially unavailable for catheterization; * did not receive or had not received oral antiplatelet drugs and/or anticoagulants for less than 3 days; * already had presence of subclavian or axillary vein catheter; * required an emergency axillary vein catheterization; * had fracture of the ipsilateral clavicle or anterior proximal ribs; * had subclavian and/or axillary vein thrombosis; * had local infection of the puncture area.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| First puncture success rate | approximately 3-5 minutes | Central venous catheter established upon first punction attempt |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| strategy success rate | within 1 hours | defined as the number of successful cannulation in targeted axillary vein within four attempts (the first two attempts using the randomized approach, third and fourth attempts using the non-randomized approach) |
| the number of attempts | within 1 hours | the number of attempts until successful cannulation |
| approach success rate | within 1 hours | the number of successful cannulation within the first two attempts |
| time to successful cannulation | within 1 hours | the time from skin puncture until completion of cannula insertion |
| Complications rate | 1 day | Complications included arterial puncture, pneumothorax, haemothorax, nerve injuries, hematoma, catheter misplacement |
| access time | within 1 hours | defined as the time between penetration of skin and aspiration of venous blood into the syringe |
Countries
China
Contacts
Primary ContactGuo-wei Tu, MD
Backup ContactYing Su, MD
Outcome results
None listed